Welcome to International Journal of Anatomy and Research

Type of Article: Original Research

Year: 2016 | Volume 4 | Issue 1 | Page No. 1954-1957

Date of Publication: 29-02-2016

DOI: http://dx.doi.org/10.16965/ijar.2016.119

MORPHOMETRIC STUDY OF PTERION

Alper Sindel ¹, Eren Ögüt ², Günes Aytaç ³, Nurettin Oguz ⁴, Muzaffer Sindel *⁵.

¹ Dt. PhD., Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Turkey.
² PhD. Student, Department of Anatomy, Akdeniz University Faculty of Medicine, Turkey.
³ MD., PhD. Student, Department of Anatomy, Faculty of Medicine, Akdeniz University, Turkey.
⁴ Professor, Akdeniz University Faculty of Medicine, Department of Anatomy, Turkey.
^*5 Professor, Department of Anatomy, Akdeniz University Faculty of Medicine, Turkey.

Address: Dr. Muzaffer Sindel, Professor, Department of Anatomy, Akdeniz University Faculty of Medicine, Turkey. Tel:00905325620900
E-Mail: sindelm@akdeniz.edu.tr

Abstract

Objective: The aim of this study is to analyze dried skulls morphometrically to determine the prevalence of the pterion types and discuss their clinical significance. There are four types of sutural pattern: sphenoparietal, the sphenoid and parietal bones are indirect contact; frontotemporal, the frontal and temporal bones are indirect contact; stellate, all the four bones meet at a point; and epipteric, when there is a small sutural bone uniting all the bones.
Material and Methods: A total number 150 adult dried skulls of unknown age and sex studied for the pterion types. For this study calvaria’s intact human skulls collected from the Akdeniz University Medical Faculty Department of Anatomy. We separated the pterions into 4 groups as sphenoparietal, frontotemporal, stellate and epipteric. We measured distances between the center of the pterion and some important points.  Morphometrical measurements are taken with digital caliper.   
Results: In the present study all types of pterion are observed. Sphenoparietal type of pterion was 63%, frontotemporal type of pterion was 2%, stellate type was 19% and epipteric type of pterion was 16% in our study. According to measurements pterion was lying aproximately 3.98 cm above the arcus zygomaticus and 3.4 cm behind the frontozygomatic suture.  
Conclusion: The pterion has close relation with the branches of middle meningeal artery and Broca’s motor speech area on the left side. Therefore knowledge and understanding of the type and location of the pterion and its relation to surrounding bony landmarks is important, especially for neurologists, neurosurgeons, radiologists and anthropologists.
Key words: Antero-Lateral Fontanelle, Stellate, Epipteric Bones.

References

1. Standring S. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 40 ed. Edinburgh: Churchill Livingstone; 2008.
2. Chao SC, Shen CC, Cheng WY. Microsurgical removal of sylvian fissure lipoma with pterion keyhole approach-case report and review of the literature. Surg Neurol. 2008;70:85-90.
3. Natekar PE, De Souza Fatima M. Epipteric bones at pterion. An anatomical study and its surgical significance. . Indian J Otol. 2010;16:44-6.
4. Ersoy M, Evliyaoglu C, Bozkurt MC, Konuskan B, Tekdemir I, Keskil IS. Epipteric bones in the pterion may be a surgical pitfall. Minim Invas Neurosur. 2003;46(6):363-5.
5. Lang J. On the Region of the Pterion and Its Clinically Important Distance from the Optic-Nerve .2. Pterion Area, Distance from the Optic-Nerve, Measurement and Form of the Space for the Temporal Pole. Neurochirurgia. 1984;27(2):31-5.
6. Oguz O, Sanli SG, Bozkir MG, Soames RW. The pterion in Turkish male skulls. Surg Radiol Anat. 2004;26(3):220-4.
7. Saxena RC, Bilodi AK, Mane SS, Kumar A. Study of pterion in skulls of Awadh area--in and around Lucknow. Kathmandu Univ Med J (KUMJ). 2003;1(1):32-3. Epub 2005/12/13.
8. Murphy T. The pterion in the Australian aborigine. Am J Phys Anthropol. 1956;14(2):225-44. Epub 1956/06/01.
9. Urzi F, Iannello A, Torrisi A, Foti P, Mortellaro NF, Cavallaro M. Morphological variability of pterion in the human skull. Ital J Anat Embryol. 2003;108(2):83-117. Epub 2003/09/25.
10. Spektor S, Valarezo J, Fliss DM, Gil Z, Cohen J, Goldman J, et al. Olfactory Groove Meningiomas from Neurosurgical and Ear, Nose, and Throat Perspectives: Approaches, Techniques, and Outcomes. Neurosurgery. 2005;57(4):268-79.
11. Lama M, Mottolese C. Middle meningeal artery aneurysm associated with meningioma. J Neurosurg Sci. 2000;44(1):39-41. Epub 2000/08/29.
12. Lindsay K, Bone, I, Callander, R,. Neurology and Neurosurgery Illustrated. 2 ed. Hong Kong, China: Churchill Livingstone; 1991.
13. Escosa-Bage M, Sola RG, Liberal-Gonzalez R, Caniego JL, Castrillo-Cazon C. Fusiform aneurysm of the middle cerebral artery. Rev Neurologia. 2002;34(7):655-8.
14. Heros RC, Lee SH. The combined pterional/anterior temporal approach for aneurysms of the upper basilar complex: technical report. Neurosurgery. 1993;33(2):244-50; discussion 50-1. Epub 1993/08/01.
15. Potapov AA, Yeolchiyan SA, Tcherekaev VA, Kornienko VN, Arutyunov NV, Kravtchuk AD, et al. Removal of a cranio-orbital foreign body by a supraorbital-pterion approach. Journal of Craniofacial Surgery. 1996;7(3):224-7.
16. Yu C, Jiang T, Guan S. [Lateral approaches for treatment of petroclival region tumor]. Zhonghua Yi Xue Za Zhi. 1999;79(12):894-6. Epub 2001/11/22.
17. Cheng WY, Lee HT, Sun MH, Shen CC. A pterion keyhole approach for the treatment of anterior circulation aneurysms. Minim Invas Neurosur. 2006;49(5):257-62.
18. Feng WF, Qi ST, Huang SP, Huang LJ. [Surgical treatment of anterior circulation aneurysm via pterion keyhole approach]. Di Yi Jun Yi Da Xue Xue Bao. 2005;25(12):1546-8, 51. Epub 2005/12/20.
19. Fishpool SJC, Suren N, Roncaroli F, Ellis H. Middle meningeal artery hemorrhage: An incorrect name. Clinical Anatomy. 2007;20(4):371-5.
20. Zalawadia D A, Vadgama D J, Ruparelia D S, Patel D S, Patel D S, V,. . Morphometric study of pterion in dry skull of Gujarat region. NJIRM. 2010;1:25-9.

Alper Sindel, Eren Ögüt, Günes Aytaç, Nurettin Oguz, Muzaffer Sindel. MORPHOMETRIC STUDY OF PTERION. Int J Anat Res 2016;4(1):1954-1957. DOI: 10.16965/ijar.2016.119